MAEA Online Proposal Form-06 * Presenter Information Name: Home Address * Home Phone Work Address Work Phone Email Membership No. Please indicate the section and program category that is appropriate for your presentation. Program Category Section Category Curriculum Concept/Program Elementary K-3 Higher Education Media Demonstration Elementary 4-6 Museum Education Theory and/or Research Middle School/Jr.High Supervision/Admn. Hands-on Workshop High School Retired Affiliate Other (describe /explain) Would you be willing to present this program/workshop more than once?   No Yes Title  of Presentation List Show-Me Standards addressed (ex, FA1, Goal 2.5, etc.) Description of Presentation ( Be brief, but as descriptive as possible) TYPE:   TIME:   AV EQUIPMENT (Spring Conference Only):   Presentation 35mm Slide Projector TV/VCR Panel Discussion 30 Min. 1 Screen 60 Min Workshop 2 Screens 90 Min. Overhead Projector Other Two Sessions Presenter supplies Equipment not listed. Date If you prefer to mail, Please print and send to: Rebecca Moppin 3108 Southwood Circle Jefferson City, MO 65101

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